School of Nursing, College of Medicine and Health Sciences and Comprehensive Specialize Hospital, University of Gondar, Gondar, Ethiopia.
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
AIDS Behav. 2022 Oct;26(10):3327-3336. doi: 10.1007/s10461-022-03610-y. Epub 2022 Apr 13.
United Nations program on HIV/AIDS 90-90-90 ambitious goal recommends 90% of people living with HIV and taking antiretroviral therapy should achieve viral suppression by 2020. However, virological failure is still a global public health problem, especially in sub-Saharan African countries. Thus, this systematic review and meta-analysis aimed at estimating the burden of virological failure and its associated factors among peoples living with HIV in sub-Saharan Africa. We searched Google Scholar, PubMed, Cochrane Library, and Scopus for studies that reported virologic failure and its associated factors. I-squared statistics and Egger's statistical test were used to detect heterogeneity and publication bias respectively. The pooled prevalence of virological failure was estimated using the DerSimonian-Laird random-effects model. Sensitivity analysis was done to check the presence of outlier results included in the studies. The estimated pooled prevalence of virological failure was 1.7.25%. Lower Adherence to ART drugs,longer ART duration, lower CD4 count,and being co-infected with TB were significantly associated with the pooled estimate of virological failure.Virological failure was found to be high in sub-Saharan Africa. Adherence, duration of ART, CD4 + count, and TB co-infection were the significant factors associated with the pooled estimate of virological failure. Therefore, to achieve the 90-90-90 target and sustainable development goal 3 policymakers should design mechanisms to improve ART adherence, and early detecting and prevent opportunistic infections such as TB.
联合国艾滋病规划署 90-90-90 宏伟目标建议，到 2020 年，90%感染艾滋病毒并接受抗逆转录病毒治疗的人应实现病毒抑制。然而，病毒学失败仍然是一个全球公共卫生问题，尤其是在撒哈拉以南非洲国家。因此，本系统评价和荟萃分析旨在估计撒哈拉以南非洲艾滋病毒感染者病毒学失败的负担及其相关因素。我们在谷歌学术、PubMed、Cochrane 图书馆和 Scopus 上搜索了报告病毒学失败及其相关因素的研究。我们使用 I 平方统计量和 Egger 统计检验分别检测异质性和发表偏倚。使用 DerSimonian-Laird 随机效应模型估计病毒学失败的汇总患病率。进行敏感性分析以检查研究中包含的异常值结果的存在。病毒学失败的估计汇总患病率为 1.725%。抗逆转录病毒药物的低依从性、较长的抗逆转录病毒治疗时间、较低的 CD4 计数以及与结核病合并感染与病毒学失败的汇总估计值显著相关。在撒哈拉以南非洲，病毒学失败的发生率很高。依从性、抗逆转录病毒治疗的持续时间、CD4+计数和结核病合并感染是与病毒学失败汇总估计值相关的重要因素。因此，为了实现 90-90-90 目标和可持续发展目标 3，政策制定者应设计机制来提高抗逆转录病毒药物的依从性，并早期发现和预防结核病等机会性感染。
